Eva Benavent1,2, Laura Morata2,3,4, Francesc Escrihuela-Vidal1, Esteban Alberto Reynaga5, Laura Soldevila1,2, Laia Albiach3, Maria Luisa Pedro-Botet5, Ariadna Padullés6, Alex Soriano2,3,4, Oscar Murillo1,2,4. 1. Infectious Diseases Department, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, University of Barcelona, 08907 Barcelona, Spain. 2. Bone and Joint Infection Study Group of the Spanish Society of Infectious Diseases and Clinical Microbiology (GEIO-SEIMC), 28003 Madrid, Spain. 3. Infectious Diseases Department, Hospital Clínic-IDIBAPS, University of Barcelona, 08036 Barcelona, Spain. 4. Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0003), Instituto de Salud Carlos III, 28029 Madrid, Spain. 5. Department of Infectious Diseases, Hospital Germans Trias i Pujol, 08916 Barcelona, Spain. 6. Department of Pharmacy, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, University of Barcelona, 08907 Barcelona, Spain.
Abstract
BACKGROUND: To evaluate the efficacy and safety of long-term use of tedizolid in osteoarticular infections. METHODS: Multicentric retrospective study (January 2017-March 2019) of osteoarticular infection cases treated with tedizolid. Failure: clinical worsening despite antibiotic treatment or the need of suppressive treatment. RESULTS: Cases (n = 51; 59% women, mean age of 65 years) included osteoarthritis (n = 27, 53%), prosthetic joint infection (n = 17, 33.3%), and diabetic foot infections (n = 9, 18%); where, 59% were orthopedic device-related. Most frequent isolates were Staphylococcus spp. (65%, n = 47; S. aureus, 48%). Reasons for choosing tedizolid were potential drug-drug interaction (63%) and cytopenia (55%); median treatment duration was 29 days (interquartile range -IQR- 15-44), 24% received rifampicin (600 mg once daily) concomitantly, and adverse events were scarce (n = 3). Hemoglobin and platelet count stayed stable throughout treatment (from 108.6 g/L to 116.3 g/L, p = 0.079; and 240 × 109/L to 239 × 109/L, p = 0.942, respectively), also in the subgroup of cases with cytopenia. Among device-related infections, 33% were managed with implant retention. Median follow-up was 630 days and overall cure rate 83%; among failures (n = 8), 63% were device-related infections. CONCLUSIONS: Long-term use of tedizolid was effective, showing a better safety profile with less myelotoxicity and lower drug-drug interaction than linezolid. Confirmation of these advantages could make tedizolid the oxazolidinone of choice for most of osteoarticular infections.
BACKGROUND: To evaluate the efficacy and safety of long-term use of tedizolid in osteoarticular infections. METHODS: Multicentric retrospective study (January 2017-March 2019) of osteoarticular infection cases treated with tedizolid. Failure: clinical worsening despite antibiotic treatment or the need of suppressive treatment. RESULTS: Cases (n = 51; 59% women, mean age of 65 years) included osteoarthritis (n = 27, 53%), prosthetic joint infection (n = 17, 33.3%), and diabetic foot infections (n = 9, 18%); where, 59% were orthopedic device-related. Most frequent isolates were Staphylococcus spp. (65%, n = 47; S. aureus, 48%). Reasons for choosing tedizolid were potential drug-drug interaction (63%) and cytopenia (55%); median treatment duration was 29 days (interquartile range -IQR- 15-44), 24% received rifampicin (600 mg once daily) concomitantly, and adverse events were scarce (n = 3). Hemoglobin and platelet count stayed stable throughout treatment (from 108.6 g/L to 116.3 g/L, p = 0.079; and 240 × 109/L to 239 × 109/L, p = 0.942, respectively), also in the subgroup of cases with cytopenia. Among device-related infections, 33% were managed with implant retention. Median follow-up was 630 days and overall cure rate 83%; among failures (n = 8), 63% were device-related infections. CONCLUSIONS: Long-term use of tedizolid was effective, showing a better safety profile with less myelotoxicity and lower drug-drug interaction than linezolid. Confirmation of these advantages could make tedizolid the oxazolidinone of choice for most of osteoarticular infections.
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